Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-57044 | CO |
N | 106S00000X | Behavior Technician |
NPI | 1003377672 |
---|---|
Provider Name | Mr. Richard A Keinz JR. |
First Address | Larkspur, CO 80118-1200 |
Second Address | Parker, CO 80134-3891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2019 |
Last Update Date | 28/12/2021 |